Radium jaw, or radium necrosis, is a historic occupational disease brought on by the ingestion and subsequent absorption of radium into the bones of radium dial painters. [1] [2] It also affected those consuming radium-laden patent medicines.
The condition is similar to phossy jaw, an osteoporotic and osteonecrotic illness of matchgirls, brought on by phosphorus ingestion and absorption.
The symptoms are necrosis of the mandible (lower jawbone) and the maxilla (upper jaw), constant bleeding of the gums, and (usually) after some time, severe distortion due to bone tumors and porosity of the lower jaw. Symptoms also include soreness throughout the body, significant decrease in body weight and loss of teeth.
Once the symptoms of radium jaw take effect, there is nothing that can be done to reduce the chance of death from radiation poisoning. Radium can cause fatal injuries due to radium and calcium sharing similar chemistry, causing the body to mistake the radioactive metal for calcium and incorporate it into bone tissue. This is significant, because while calcium strengthens bone structures, radium degrades the quality of said bone structure. Alpha particles emitted by the radium lead to bone necrosis and bone cancer. [3]
At the start of the 20th century, many believed that radium had beneficial health properties and was often added to consumer products such as toothpaste, hair creams, and even food. Used until the early 1970s, radium was found in some consumer paints, dials on clocks and some industrial applications. Radium was also used in some medical practices during the 20th century. [4]
The disease was determined by pathologist Dr. H.S. Martland in 1924 to be symptomatic of radium paint ingestion, after many female workers from various radium paint companies reported similar dental and mandibular pain. The first written reference to the disease was by a dentist, Dr. Theodor Blum, in 1924, who described an unusual mandibular osteomyelitis in a dial painter, naming it "radium jaw". [5] Symptoms were present in the mouth due to use of the lips and tongue to keep the radium-paint paintbrushes properly shaped. The disease was the main reason for litigation against the United States Radium Corporation by the Radium Girls, female factory workers who contracted radiation poisoning from painting watch dials with self-luminous paint in the early 20th century. [6]
A prominent example of this condition was the death of American golfer and industrialist Eben Byers in 1932, after taking large doses of Radithor, a radioactive patent medicine containing radium, over several years. His illness garnered much publicity, and brought the problem of radioactive quack medicines into the public eye. The Wall Street Journal ran a story (in 1989 or after) titled "The Radium Water Worked Fine until His Jaw Came Off". [7]
Stories such as the Radium Girls and Eben Byers death went public and due to public pressure/outrage, the Food and Drug Administration banned most radiation-based patent medicines in 1932. [8]
Radium is a chemical element with the symbol Ra and atomic number 88. It is the sixth element in group 2 of the periodic table, also known as the alkaline earth metals. Pure radium is silvery-white, but it readily reacts with nitrogen (rather than oxygen) upon exposure to air, forming a black surface layer of radium nitride (Ra3N2). All isotopes of radium are radioactive, the most stable isotope being radium-226 with a half-life of 1,600 years. When radium decays, it emits ionizing radiation as a by-product, which can excite fluorescent chemicals and cause radioluminescence.
Ebenezer McBurney Byers was an American socialite, sportsman, and industrialist. He won the 1906 U.S. Amateur in golf. He died from multiple radiation-induced cancers after consuming Radithor, a patent medicine made from radium dissolved in water.
Alveolar osteitis, also known as dry socket, is inflammation of the alveolar bone. Classically, this occurs as a postoperative complication of tooth extraction.
The Radium Girls were female factory workers who contracted radiation poisoning from painting radium dials – watch dials and hands with self-luminous paint. The incidents occurred at three factories in the United States: one in Orange, New Jersey, beginning around 1917; one in Ottawa, Illinois, beginning in the early 1920s; and one in Waterbury, Connecticut, also in the 1920s.
Radithor was a patent medicine that is a well-known example of radioactive quackery and specifically of excessively broad and pseudoscientific application of the principle of radiation hormesis. It consisted of triple-distilled water containing at a minimum 1 microcurie (37 kBq) each of the radium 226 and 228 isotopes.
Radioluminescence is the phenomenon by which light is produced in a material by bombardment with ionizing radiation such as alpha particles, beta particles, or gamma rays. Radioluminescence is used as a low level light source for night illumination of instruments or signage. Radioluminescent paint is occasionally used for clock hands and instrument dials, enabling them to be read in the dark. Radioluminescence is also sometimes seen around high-power radiation sources, such as nuclear reactors and radioisotopes.
Luminous paint is paint that emits visible light through fluorescence, phosphorescence, or radioluminescence.
Cherubism is a rare genetic disorder that causes prominence in the lower portion in the face. The name is derived from the temporary chubby-cheeked resemblance to putti, the chubby-faced infants featured in Renaissance paintings, which were often mistakenly described as cherubs.
Radium bromide is the bromide salt of radium, with the formula RaBr2. It is produced during the process of separating radium from uranium ore. This inorganic compound was discovered by Pierre and Marie Curie in 1898, and the discovery sparked a huge interest in radiochemistry and radiotherapy. Since elemental radium oxidizes readily in air and water, radium salts are the preferred chemical form of radium to work with. Even though it is more stable than elemental radium, radium bromide is still extremely toxic, and can explode under certain conditions.
Radium dials are watch, clock and other instrument dials painted with luminous paint containing radium-226 to produce radioluminescence. Radium dials were produced throughout most of the 20th century before being replaced by safer tritium-based luminous material in the 1970s and finally by non-toxic, non-radioactive strontium aluminate–based photoluminescent material from the middle 1990s.
Osteonecrosis of the jaw (ONJ) is a severe bone disease (osteonecrosis) that affects the jaws. Various forms of ONJ have been described since 1861, and a number of causes have been suggested in the literature.
Undark was a trade name for luminous paint made with a mixture of radioactive radium and zinc sulfide, as produced by the U.S. Radium Corporation between 1917 and 1938. It was used primarily in watch and clock dials. The people working in the industry who applied the radioactive paint became known as the Radium Girls because many of them became ill and some died from exposure to the radiation emitted by the radium contained within the product. The product was the direct cause of radium jaw in the dial painters. Undark was also available as a kit for general consumer use and marketed as glow-in-the-dark paint.
The United States Radium Corporation was a company, most notorious for its operations between the years 1917 to 1926 in Orange, New Jersey, in the United States that led to stronger worker protection laws. After initial success in developing a glow-in-the-dark radioactive paint, the company was subject to several lawsuits in the late 1920s in the wake of severe illnesses and deaths of workers who had ingested radioactive material. The workers had been told that the paint was harmless. During World War I and World War II, the company produced luminous watches and gauges for the United States Army for use by soldiers.
Radiobiology is a field of clinical and basic medical sciences that involves the study of the effects of ionizing radiation on living things, in particular health effects of radiation. Ionizing radiation is generally harmful and potentially lethal to living things but can have health benefits in radiation therapy for the treatment of cancer and thyrotoxicosis. Its most common impact is the induction of cancer with a latent period of years or decades after exposure. High doses can cause visually dramatic radiation burns, and/or rapid fatality through acute radiation syndrome. Controlled doses are used for medical imaging and radiotherapy.
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s.
A jaw abnormality is a disorder in the formation, shape and/or size of the jaw. In general abnormalities arise within the jaw when there is a disturbance or fault in the fusion of the mandibular processes. The mandible in particular has the most differential typical growth anomalies than any other bone in the human skeleton. This is due to variants in the complex symmetrical growth pattern which formulates the mandible.
William John Aloysius Bailey was an American patent medicine inventor and salesman. A Harvard University dropout, Bailey falsely claimed to be a doctor of medicine and promoted the use of radioactive radium as a cure for coughs, flu, and other common ailments. Although Bailey's Radium Laboratories in East Orange, New Jersey, was continually investigated by the Federal Trade Commission, he died wealthy from his many devices and products, including an aphrodisiac called Arium, marketed as a restorative that "renewed happiness and youthful thrill into the lives of married peoples whose attractions to each other had weakened."
Osteoradionecrosis (ORN) is a serious complication of radiation therapy in cancer treatment where radiated bone becomes necrotic and exposed. ORN occurs most commonly in the mouth during the treatment of head and neck cancer, and can arise over 5 years after radiation. Common signs and symptoms include pain, difficulty chewing, trismus, mouth-to-skin fistulas and non-healing ulcers.
Osteomyelitis of the jaws is osteomyelitis which occurs in the bones of the jaws. Historically, osteomyelitis of the jaws was a common complication of odontogenic infection. Before the antibiotic era, it was frequently a fatal condition.
Theodor Blum has been described as “the most outstanding oral surgeon in America”... He was a pioneer in local anesthesia, in the use of x-rays in dental care, and in the management of many pathologic oral conditions. He was a founder of The New York Institute of Clinical Oral Pathology. Through his work and a few others, oral pathology gained recognition as a medical specialty. He was the first to make use in medical literature of the term “radium jaw” that arose from a case he treated that is described in the book The Radium Girls (2016).
